154 



CANINE AND FELINE SURGERY 



flow must be removed by the careful reintroduction of the 

 trocar or a sterihzed blunt probe. 



The left side may or may not, at the discretion of the 

 operator, be punctured in the same way. On this side, 

 when choosing the site of puncture, the portion of chest wall 

 immediately over the heart-beat must be avoided, the trocar 

 being inserted very cautiously just through the pleura in a 

 slanting direction,and then withdrawn, the rest of the puncture 

 being made with the blunt cannula. 



The author has seen one of the heart ventricles accidentally punctured, 

 the blood spurting out with each heart-beat. The patient was kept under 

 close obser\ation afterwards for a week, and appeared to suffer no 

 inconvenience. 



Fig. 120. — Trocars and Cannute : Various Sizes (nested). 



Symptoms of collapse mmst be watched for, and the 

 amount of fluid withdrawn left entirely to the discretion of 

 the operator. The author's opinion is that as much as 

 possible should be withdrawn unless signs of syncope appear, 

 as it is practically impossible to entirely empty the dog's chest, 

 on account of its shape. 



Solution of iodine, chinosol, adrenalin chloride, or some 

 antiseptic may, or may not, be injected, after which the 

 cannula is carefully and slowly withdrawn. 



The seat of puncture is dried with aseptic cotton-wool, and 

 covered with iodoform (or orthoform) and collodion. 



Of these, adrenalin chloride is the one with which the most favourable 



results have been recorded. It was first advocated in the treatment of 



erous effusions by Dr. Barr, of Liverpool, in 1903, and Drs. Plant and 



